MEDICARE: KASHA FARAHANI DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	27915	CA

General Provider Information

NPI Number	:	1902026040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KASHA FARAHANI DPT

Provider Business Mailing Address
First Line	:	9430 VERVAIN ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92129-3527
Country	:	US
Telephone Number	:	858-245-6957
Fax Number	:

Provider Business Practice Location Address
First Line	:	17895 CAMINITO PINERO UNIT 257
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-4806
Country	:	US
Telephone Number	:	858-245-6957
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2007
Last Update Date	:	04/08/2024

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